Perspectives and future challenges in PTLD
| Aspect . | Research/clinical challenges/opportunities . |
|---|---|
| Incidence | Integrating large registries and complete multicenter/nationwide detailed information, preferentially prospective |
| Risk factors | Searching for tools measuring overall immunosuppressive load and association with PTLD risk and identifying new risk factors (HLA associated? Non-EBV viruses?) |
| Pathogenesis | Providing comprehensive overview of genomic landscape by using next-generation sequencing (both EBV+ and EBV− PTLD) |
| Diagnosis | Refining WHO 2008 classification, including impact of EBV (negative, positive, latency type, lytic activation), stromal microenvironment, and molecular genetic findings |
| Staging and response assessment | Determining role of hybrid PET/magnetic resonance imaging, other tracers (eg, 18F-fluoro-3′-deoxythymidine), and immuno-PET |
| Prevention | Improving preemptive strategies (eg, EBV PCR, cytokine gene polymorphisms, and chemokine (C-X-C motif) ligand 13) |
| Treatment | Aiming for international cooperation and inclusion of patients in prospective international trials |
| Prognosis | Identifying new (clinical and nonclinical) prognostic factors and factors predictive for response, aiming to identify patients with poor outcome on “standard” therapy and provide an opportunity for risk-adapted treatment strategies in the future |
| Aspect . | Research/clinical challenges/opportunities . |
|---|---|
| Incidence | Integrating large registries and complete multicenter/nationwide detailed information, preferentially prospective |
| Risk factors | Searching for tools measuring overall immunosuppressive load and association with PTLD risk and identifying new risk factors (HLA associated? Non-EBV viruses?) |
| Pathogenesis | Providing comprehensive overview of genomic landscape by using next-generation sequencing (both EBV+ and EBV− PTLD) |
| Diagnosis | Refining WHO 2008 classification, including impact of EBV (negative, positive, latency type, lytic activation), stromal microenvironment, and molecular genetic findings |
| Staging and response assessment | Determining role of hybrid PET/magnetic resonance imaging, other tracers (eg, 18F-fluoro-3′-deoxythymidine), and immuno-PET |
| Prevention | Improving preemptive strategies (eg, EBV PCR, cytokine gene polymorphisms, and chemokine (C-X-C motif) ligand 13) |
| Treatment | Aiming for international cooperation and inclusion of patients in prospective international trials |
| Prognosis | Identifying new (clinical and nonclinical) prognostic factors and factors predictive for response, aiming to identify patients with poor outcome on “standard” therapy and provide an opportunity for risk-adapted treatment strategies in the future |